I have looked previously at this issue previously
http://healthjournalclub.com/things-that-make-you-go-hmmm/
The problem isn't finding drugs that alter LDL and HDL
levels, there are plenty of these. It's that they all
keep showing at best zero clincal effect or many times
an increase in mortality. The whole good guy/bad guy
routine appears to be wearing thin at this point..

Enlightened Progressive

11/16/11

Repeated stenting and heart attacks during a decade
and a half that I have faithfully taken statins have
shown me that taking statins in low HDL patients is
almost useless. The only thing that has retarded my
rate of disease somewhat is my daily 1000 mg of ring-
bound slow release Niacin, admittedly not the best
source of Niacin, but since prescription slow-release
Niacin is a total farce at 400.00 a month, the OTC
product at 13.00 for 50 x 1000mg will do. The
supposedly ineffective product has raised my HDL from
about 26 to 46. I would like to try the Crestor or
Lipitor, but at 20 mg / day Simvastatin the occasional
bouts of bilateral epicondylitis and other tendon
morbidities are evidence that statins are dangerous
medicine, even at this low dose..

margaret swartz

11/16/11

There have been hundreds, if not thousands of case
studies of the positive effects of niacin and the
reduction of LDL. This study was bogus from the start.
Aside from the fact that LDL is not a risk factor for
heart disease and that it's required in the body to
seal damage in arteries and veins, what's the point?
People need an amount of cholesterol to be healthy. At
the levels in the study, that should be
considered &quot;healthy&quot;. The drugs used to control
cholesterol are hazzardous to your health and cause
more problems than they prevent. Lipitor, rarely
lowers levels enough to make the expense or the side
effects worth the effort..

avi geerick

11/16/11

As a physical scientist, I would be fired from my
research if I were to stop a study early.
Atherosclerosis takes years to build up, and may take
years to reverse. Those who stopped the study early
robbed us of a chance to find out, and should be
removed from their authoritative positions!.

Edmond Hooker, MD, DrPH

11/16/11

The study was flawed. As much as anything, they used
the wrong form of Niacin. Niacor is the only currently
available USP certified rapid release niacin. I think
the numbers would have been significantly different
with the use of rapid release. In a case study of one,
me, I take 1000 mg of Niacor twice daily. I have
absolutely no flushing because I take it 30 minutes
after eating. My HDL has gone from 39 to 84 and
maintained that for 8 years. My coronary artery disease
has not progressed at all in 8 years (just had a cath
last month). I also take vytorin 10/20. Niacor is less
then 25% of the cost of Niaspan. It is important to
remember not to take niacin from the natural food
store. It is not manufactured by USP standards and may
have too little or too much niacin..

Dr. Dubrawsky

11/16/11

"This study was bogus from the
start"(Margaret Swartz). I agree.
To come to the public and state that Niacin is bad for
you is bad enough. But to come to the public and tell
it that though Niacin is bad (In the Niaspam form) you
should continue taking it is worse.
Where is the "Beef"? Pure
Niacin, Niacin IR, Crystallin Niacin, Niacin Immediate
Release is a pure "Self"
Molecule-OriginalMolecule. Molecule of the Body.
Niacin is the best to elevate H.D.L. and lower
Triglycerides. Period.
Niacin extended release, Niaspam, Niacin slow release, is
NOT a Self Molecule. This is foreign molecule that the
body will fight!!! Do I have to remind the public about
the side effects? What about the flush? What about the
flush!!!. The flush is a non issue if you take Niacin
IR as a 50-100 mg. tablet twice a day, with a bite of
bread.
What is the Half Life of Niacin IR? 28-45 minutes!
What is the "best" Side
effect of Niacin? It improves your cognition. You become
smarter.
In summary:A good pill is the one which acts like a
smart bomb and not a cluster bomb (Cleveland Clinic
Journal of Medicine,2007,Letter to the editor)
So "Where is the beef?" The
solution will come when the Innate Immunity will be
invented. Ref.C.A.Janeway "Future direction
of research in immunobiology."
Immunobiology(Textbook).2001.Garland Publishing.Pp.608-
615..

SCR

11/16/11

Pharma can't make money off of niacin. Look at the disclosures from the
authors of this study. How sad.
The study was funded by the National Heart, Lung, and Blood Institute
and Abbott Laboratories, which donated niacin, placebo, and ezetimibe
used in the trial.
Merck donated simvastatin (Zocor) used in the trial.
McBride reported being employed by Axio Research.
Boden reported receiving consulting fees from Abbott.
Giugliano reported consulting for Amgen, Regeneron, Merck, and sanofi-
aventis; grants paid or pending from Amgen; and payment for lectures
from Merck, sanofi-aventis, and Bristol Myers-Squibb.
Breslow and Maningat reported having no conflicts of interest to disclose..

Tami Djernes, RN

11/16/11

A whole (no processed foods) plant-based (vegan) diet
is more effective at lowering LDL and preventing
cardiac events than any pharmaceutical or procedure.
Check out the research of Caldwell Esselstyn MD of
Cleveland Clinic and his success at reversing severe
heart disease. My husband (a neurologist) and I
(coronary care nurse) have been eating a whole foods
vegan diet for 17 months. My husbands total cholesterol
dropped from 260 to 190 (without a statin) and mine
dropped from 210 to 170 after changing our diet. We
both dropped from BMI's of 25 to BMI's of 21 (I lost 30
pounds, he lost 39 pounds). We did not restrict
calories, skip meals, or go hungry. We filled up on
fruit, vegetables, legumes, and whole grains. It was
the easiest weight loss I've ever achieved and I will
never go back to a diet of meat, eggs, dairy, and
processed foods. These foods were addicting. I had to
completely eliminate them from my diet to lose the
craving for them. Giving up the Standard American Diet
is similar to giving up cigarettes--it's difficult at
first, but the benefits are so enormous that you don't
want to go back to your old bad habits..

justin isert

11/17/11

The study raises more questions than it answers. It
also raises a lot of doubts about the value of
lowering HDL especially when one considers the side
effects and the expense of medicine..

que dodieu

11/18/11

So far,there has been a broad consensus that higher
HDL cholesterol levels are cardioprotective.Thus,
people are frequently advised to keep HDL cholesterol
levels above 40 mg/dl.
In addition,several studies have shown that healthy
HDL levels in elderly can help preserve function of
brain cells and protect against mental decline and low
HDL cholesterol are linked with a high risk of death
from coronary artery disease and stroke.
Along with statin,niacin has possesed that function:
increases HDL cholesterol levels which explains that
niacin also has both the above outcomes.
Furthermore,despite some researchs have not
recommended that lowering triglyceride levels will
necessarily to improve heart health,but lowering
triglyceride levels are all heart healthy and many
result in an improved cholesterol ratio,which also
play a role in taming CVD.
Niacin,what a wonder drug !so I wondered why "niacin
boosts HDL cholesterol with no benefit for clinical
outcomes in otherwise well-treated patients " and "
there was no difference in rates of CHD death,ischemic
stroke.."between patients who received niacin compared
with placebo..

tom hennessy

11/20/11

Quote: "Niacin has a number of metabolic effects; it
doesn't just raise HDL, it lowers triglycerides, it
lowers lipoprotein A, which we know is a potent
atherogenic factor, and we have very few agents that
lower that factor."
Answer: "Left in a coma and was dying" "Used a stomach
tube and gave him a large dose of niacin and ascorbic
acid" "The next day he sat up" "Thirty days later he
was well.".

Albert Baily

12/05/11

I (a retired medico with signficant family hist of
cardiovascular related morbidity and mortality) have
been taking Nicotinic Acid Tablets 250mgs-4 tablets
three times a day ie 3 grams/day and Gemfibrizol 600mgs
bd, for the last 15 years.Plus my cardiologist after
trying me unsuccessfully on various statins with bad
side-effects, has over the last 2.5 years prescribed me
Crestor 5mg at night and Ezotril 10mg tablet 1 daily.My
LDL has gone down cosiderably as has the total
cholesterol count.(LDL from 4milimols to 1.8
milmols;HDL has raised from 0.7milimols to 1.1
milimols;Total Cholesterol down from 9 milimols to 4
milimols;Triglycerides down from 4.2milimols to 1.9
milimols)Apart from some flushing on the first day of
starting the Nic Acid, I have had no side effects.Not
surprisingly both I and my cardiologist are happy with
the tight control of my lipid profile.It is a pity that
the Australian government run scheme of
PBS(Pharmaceutical Benefit Scheme)which provides
subsidized therapeutic goods to eligible Australian
citizens withdrew Nicotinic Acid as a benefit item some
4 years ago! I realise that One swallow does not make
the summer, but I am convinced from my personal
experience that Nicotinic Acid (the fast release
crystallin form)has a definite role in our therapeutic
armamentarium.Let us not throw the baby out with the
bath water.Let us not forget many hundreds of well
researched articles indicating the efficacy of Nic Acid
over the dacades..

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